Injector, intraocular lens system, and related methods

ABSTRACT

An intraocular lens system may include a base that may include an annular body, an opening extending through the annular body in an axial direction of the annular body, and a recess extending circumferentially about the opening. The system also may include a lens that may be insertable into and removable from the recess. The lens may include a central optic, a first tab protruding radially away from the central optic, and a second tab protruding radially away from the central optic. The second tab may be more resistant to compression in a radial direction than the first tab. The first tab may include a first arm protruding radially away from the central optic, a second arm protruding radially away from the central optic and extending away from the first arm, and a third arm extending from the first arm to the second arm. Movement of one or more of the first, second, and third arms may result in deformation of the first tab.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application claims the benefit under 35 U.S.C. § 119 to U.S.Provisional Patent Application No. 62/525,317, filed on Jun. 27, 2017;and to U.S. Provisional Patent Application No. 62/534,988, filed on Jul.20, 2017, each of which is incorporated herein by reference in itsentirety.

TECHNICAL FIELD

The present disclosure generally relates to intraocular lens (IOL)systems and related injectors. More specifically, the present disclosurerelates to various embodiments of modular IOL systems and injectordesigns for improved injection of IOL components into an eye.

BACKGROUND

The human eye functions to provide vision by transmitting light througha clear outer portion called the cornea, and focusing the image by wayof a crystalline lens onto a retina. The quality of the focused imagedepends on many factors including the size and shape of the eye, and thetransparency of the cornea and the lens.

When age or disease causes the lens to become less transparent (e.g.,cloudy), vision deteriorates because of the diminished light, which canbe transmitted to the retina. This deficiency in the lens of the eye ismedically known as a cataract.

An accepted treatment for this condition is surgical removal of the lensfrom the capsular bag and placement of an artificial intraocular lens(IOL) in the capsular bag. Cataractous lenses are removed by a surgicaltechnique called phacoemulsification. During this procedure, an opening(capsulorhexis) is made in the anterior side of the capsular bag and athin phacoemulsification-cutting tip is inserted into the diseased lensand vibrated ultrasonically. The vibrating cutting tip emulsifies thelens so that the lens may be aspirated out of the capsular bag.

The diseased lens, once removed, is replaced by an IOL that is insertedinto the eye using an injector, and maneuvered into the empty capsularbag. In some instances, the IOL may become stuck in the injector, or theIOL may become damaged as a result of poor technique or training, as inthe case of a damaged trailing IOL haptic. Improvements in injectordesign are needed to address this problem.

SUMMARY

Embodiments of the present disclosure provide an injector for injectingone or more components of an IOL system into the eye, the injectorhaving a housing, a cartridge for holding the IOL system component, adistal nozzle having a tapered lumen and a plunger having a tip disposedin a channel of the housing. The plunger tip may have two arms thatchange from an expanded configuration when disposed in the proximal endof the nozzle lumen and a contracted configuration when disposed in thedistal end of the nozzle lumen.

The arms may have a gap between them that decreases as the arms passthrough the nozzle. The arms may remain in contact with the inner wallof the nozzle lumen as the arms pass through the nozzle. The distal endsof the arms may be free or attached to a collapsible link, for example.The arms may include inwardly extending fingers that are offset relativeto each other such that they bypass each other as the arms move towardeach other. The fingers may be configured to prevent the IOL systemcomponent from passing through the gap between the arms.

The distal end of the arms or the distal end of the link may include abevel with a distal-most edge and a distal-facing surface. Thedistal-facing surface may be configured to engage and push the IOLsystem component. The distal-most edge may be in contact with the innerwall of the nozzle lumen to prevent the IOL system component frompassing between the arm and the inner wall as the IOL system componentpasses through the nozzle.

Embodiments of the present disclosure also provide a modular IOL systemcomprising a primary component, such as a base, and a secondarycomponent, such as a lens.

According to one aspect of the present disclosure, an intraocular lenssystem may include a base that may include an annular body, an openingextending through the annular body in an axial direction of the annularbody, and a recess extending circumferentially about the opening. Thesystem also may include a lens that may be insertable into and removablefrom the recess. The lens may include a central optic, a first tabprotruding radially away from the central optic, and a second tabprotruding radially away from the central optic. The second tab may bemore resistant to compression in a radial direction than the first tab.The first tab may include a first arm protruding radially away from thecentral optic, a second arm protruding radially away from the centraloptic and extending away from the first arm, and a third arm extendingfrom the first arm to the second arm. Movement of one or more of thefirst, second, and third arms may result in deformation of the firsttab.

According to another aspect of the present disclosure, an intraocularlens system may include a base including an annular body, an openingextending through the annular body in an axial direction of the annularbody, and a recess extending circumferentially about the opening. Thesystem also may include a lens configured for insertion into andremovable from the recess. The lens may include a central optic, a firsttab extending radially away from the central optic, and a second tabextending radially away from the central optic. The second tab may bemore resistant to compression than the first tab. The first tab mayinclude a first arm extending radially away from the central optic, asecond arm extending radially away from the central optic, and a thirdarm extending between the first arm with the second arm. One or more ofthe first, second, and third arms is configured to deform to move thefirst tab between a compressed state and an extended state. In theextended state of the first tab, an obtuse angle may be formed betweenthe first and second arms.

According to another aspect of the present disclosure, a method forassembling an intraocular lens system may include inserting one of: (a)a first tab and (b) a second tab, of a lens of the intraocular lenssystem, into a recess of a base of the intraocular lens system. Thesecond tab may be more resistant to compression than the first tab. Thelens may include a central optic, the first tab extending radially awayfrom the central optic, and the second tab extending radially from thecentral optic. The first tab may include a first arm extending radiallyaway from the central optic, a second arm extending radially away fromthe central optic and away from the first arm, and a third arm linkingthe first and second arms. The base may include an annular body and anopening extending through the annular body in an axial direction of theannular body. The recess may extend circumferentially about the opening.The method also may include inserting the other of the first and secondtabs into the recess. The other of the first and second tabs may beinserted into the recess while the at least one of the first and secondtabs is in the recess.

Various other aspects and advantages of embodiments of the presentdisclosure are described in the following detailed description anddrawings. It may be understood that both the foregoing generaldescription and the following detailed description are exemplary andexplanatory only and are not restrictive of the invention, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate exemplary embodiments of thepresent disclosure and together with the description, serve to explainthe principles of the disclosure. The drawings are not necessarily toscale, may include similar elements that are numbered the same, and mayinclude dimensions (in millimeters) and angles (in degrees) by way ofexample, not necessarily limitation. In the drawings:

FIG. 1A is an exploded view of an IOL system injector according to anembodiment of the present disclosure;

FIG. 1B is an assembly view of the IOL system injector shown in FIG. 1A;

FIG. 2 is a side view of a plunger of the IOL system injector shown inFIGS. 1A and 1B;

FIG. 2A is a close-up side view of a tip of the plunger shown in FIG. 2;

FIG. 2B is a close-up end view of the tip of the plunger shown in FIG.2;

FIG. 2C is a close-up perspective view of the tip of the plunger shownin FIG. 2;

FIG. 3A is a close-up perspective view of an alternative plunger tip;

FIG. 3B is a close-up perspective view of another alternative plungertip;

FIGS. 4A to 4C are schematic illustrations showing how the tip of theplunger of FIG. 2 is squeezed as the tip passes through a nozzle;

FIG. 5 is a perspective view of a base of a modular IOL system;

FIG. 5A is a cross-sectional view taken along line A-A in FIG. 5;

FIG. 6 is a top view of a lens of a modular IOL system;

FIG. 7 is a perspective view of a loading cartridge for use in the IOLsystem injector shown in FIGS. 1A and 1B;

FIG. 7A is an end view of the loading cartridge shown in FIG. 7;

FIG. 7B is a cross-sectional view taken along line B-B in FIG. 7A;

FIG. 7C is the same cross-sectional view shown in FIG. 7B with a basepositioned therein;

FIG. 8 is a perspective view of an alternative holder for use in the IOLsystem injector shown in FIG. 1;

FIG. 8A is a close-up perspective view of the holder shown in FIG. 8;and

FIG. 8B is a close-up perspective view of the holder shown in FIG. 8with a base positioned therein.

DETAILED DESCRIPTION Overview

The following detailed description describes various embodiments of IOLsystem injectors. Features described with reference to any oneembodiment may be applied to and incorporated into other embodiments.

Exemplary Embodiments

With reference to FIG. 1A, IOL system injector 10 generally includes aninjector housing 20, a plunger 30, a loading cartridge 40, a nozzle(a.k.a. cartridge tip) 50 and a spring 60. The housing 20 includesfinger grips 22, a nozzle holder 24, a cartridge holder 26 and aninternal channel 28 extending therethrough. The plunger 30 includes athumb pad 32, a proximal shaft 34, a distal shaft 36 and a plunger tip70. The IOL system loading cartridge 40 includes a first folding wing42, a second folding wing 44 with a locking mechanism, and a chamber 46configured to hold the IOL system when the wings 42, 44 are closed. Thenozzle 50 includes an internal lumen (not visible) that has a decreasingcross-sectional area proximal to distal. The nozzle 50 also includes abeveled tip 52 for insertion into the incision in the eye.

The injector 10 is modular in nature such that the nozzle 50 may beinserted into the nozzle holder 24 of the housing 20, the cartridge maybe inserted into the cartridge holder 26 of the housing 20, the spring60 may be disposed on the distal shaft 36 of the plunger 30, and theplunger 30 together with spring 60 may be inserted into the channel 28of the housing 20 to form an assembled IOL system injector 10 as shownin FIG. 1B.

With this arrangement, an IOL system component may be loaded orpre-loaded in the chamber 46 of the loading cartridge 40. The loadingcartridge 40 is placed in the cartridge holder 26 in the housing 20.Then, the wings 42, 44 are folded or closed to essentially roll or foldthe IOL system component such that it has a reduced profile suitable forinjection. Using one hand with two fingers on the finger grips 22 of thehousing 20 and a thumb on the thumb pad 32 of the plunger 30, theplunger 30 may be advanced distally through the channel 28 in thehousing 20 until the tip 70 of the plunger 30 engages the IOL systemcomponent in the loading cartridge 40. With the tip 52 of the nozzleinserted into the incision in the eye, further advancement of theplunger 30 pushes the IOL system component out of the loading cartridge40 and into the nozzle 50. As the plunger tip 70 and the IOL systemcomponent are pushed through the nozzle 50, the tapered lumen in thenozzle 50 further reduces the profile of the rolled IOL system componentmaking it suitable for injection through a micro incision in the eye.The plunger 30 may then be advanced further until the IOL systemcomponent exits the tip 52 of the nozzle 50 and is thus delivered intothe eye.

With the exception of the plunger 30 and its associated features (andthe alternative loading cartridge and holder described hereinafter), theother components of the injector 10 may be similar to an injector soldunder the trade name Accuject 2.2-HT from Medicel, Switzerland. As willbe described in more detail hereinafter, the plunger 30 has a number ofunique attributes. Thus, the features of the plunger 30 may beincorporated into other injector designs known in the art.

With reference to FIG. 2, the plunger 30 is shown in more detail. Asstated above, the plunger 30 includes a thumb pad 32, a proximal shaft34, a distal shaft 36 and a tip 70. The tip 70 is shown in more detailin FIGS. 2A, 2B and 2C. Plunger tip 70 includes a first (top) arm 72 anda second (bottom) arm 74. The arms 72, 74 are connected to and extenddistally from the distal shaft 36. The distal ends of the arms 72, 74may be free as shown, with no connection therebetween.

The arms 72, 74 are flexible and pivot about their connection to thedistal shaft 36 such that they that can change from an expandedconfiguration when disposed in the proximal end of the lumen in thenozzle 50 and a contracted configuration when disposed in the distal endof the lumen in the nozzle. The arms 72, 74 have a gap between them thatdecreases as the arms 72, 74 pass through the nozzle 50. In other words,the arms 72, 74 are squeezed together as the tip 70 passes through thenozzle 50. The outwards facing surfaces of the arms 72, 74 remain incontact with the inner wall of the lumen in the nozzle 50 as they passtherethrough.

Fingers 76, 78 extend inwardly in a proximal-turning curve from the arms72, 74, respectfully. The proximal ends of the fingers 76, 78 may beattached to the arms 72, 74 at a location set back from the distal-mostend of the arms 72, 74, and the distal ends of the fingers 76, 78 may befree, as shown. As best seen in FIG. 2B, the fingers 76, 78 may belaterally off-set relative to each other such that they bypass eachother as the arms 72, 74 are squeezed together.

As seen in FIG. 2B, the profile of the arms 72, 74 may be configured(e.g., in an end-view rectangular profile with a height greater than awidth) such that the top side of the top arm 72 and the bottom side ofthe bottom arm 74 remain in contact with the inner wall defining thelumen in the nozzle 50, but the lateral sides of the arms 72, 74 do not.This configuration allows the arms 72, 74 together with the fingers 76,78 to span across the entire lumen in the nozzle 50 in one direction toprevent the tip 70 from bypassing the IOL system component as the tip 70is advanced through the nozzle 50, which otherwise could lead to a stuckIOL in the nozzle 50. Also, because the lateral sides of the arms 72, 74do not contact the inner wall defining the lumen in the nozzle 50, spaceis provided therebetween for the trailing haptic of the IOL systemcomponent if the plunger tip 70 bypasses it, allowing the haptic to bereleased as it exits the tip 52 of the nozzle 50, thus preventing astuck IOL system component in the nozzle 50. This configuration alsoreduces friction between the tip 70 and the inner wall defining thelumen in the nozzle 50 because the only the top and bottom sides of thearms 72, 74 are in contact with the inner wall, and the lateral sidesare not.

With continued reference to FIGS. 2A and 2B, dimensions are provided byway of example, not necessarily limitation. The arms 72, 74 may have anexpanded (unconstrained) height that is greater than the inside diameterof the lumen in the nozzle 50 and greater than the outside diameter ofthe distal plunger shaft 36 such that they flare outwardly and distally.Each arm 72, 74 may have an overall length that is at least two timesgreater than their expanded height. The height and width of each arm 72,74 may be at least five times less than their overall length and theirheight may taper along their length. The arms 72, 74 may bediametrically opposed (i.e., 180 degrees apart) and their overall lengthmay be approximately equal.

As seen best in FIG. 2C, a bevel 80 may be provided on the distal end ofone or both arms 72, 74. The bevel 80 may include a distal-most edge 82and a distal-facing surface 84. The bevel 80 may slope in a proximal andinward direction, away from the inner wall of the lumen in the nozzle50, such that the edge 82 is in contact with the inner wall and theslope of the bevel 80 biases the IOL system component away from theinner wall. This configuration mitigates against the IOL systemcomponent becoming stuck between the tip 70 and the inner wall of thelumen in the nozzle 50 as the tip 70 is advanced through the nozzle 50.

With reference to FIG. 3A, an alternative plunger tip 70 is shown indetail. In this embodiment, the plunger tip 70 does not include fingers76, 78, but rather includes link 90 extending from and between thedistal ends of the arms 72, 74. Other aspects of the plunger tip 70 maybe the same or similar as described previously. Link 90 may include ahinge and/or may be formed of highly flexible material to allow it tocollapse as the arms 72, 74 are squeezed together as they are advancedthrough the nozzle 50. This configuration allows the arms 72, 74together with the link 90 to span across the entire lumen in the nozzle50 in one direction to prevent the tip 70 from bypassing the IOL systemcomponent as the tip 70 is advanced through the nozzle 50, whichotherwise could lead to a stuck IOL system component in the nozzle 50.The link 90 may include bevels 80 that function as described above.

With reference to FIG. 3B, another alternative plunger tip 70 is shownin detail. In this embodiment, the plunger tip 70 does not includefingers 76, 78, but rather includes a tongue 96 extending from arm 74into a groove defined by walls 92, 94 extending from arm 72. Otheraspects of the plunger tip 70 may be the same or similar as describedpreviously. This tongue and groove arrangement may serve the same orsimilar purpose as fingers 76, 78.

With reference to FIGS. 4A-4C, advancement of the plunger tip 70 throughthe lumen in the nozzle (a.k.a. cartridge tip) 50 is schematicallyillustrated in step-wise fashion. For this purpose, the nozzle 50 isshown in transparent view with distal beveled tip 52, distal opening 54and through lumen 56, and only a distal portion of the plunger 30including tip 70 is shown. As mentioned previously, the cross-sectionalarea or diameter of the lumen 56 in the nozzle 50 gradually decreasesfrom proximal to distal end. As such, the arms 72, 74 are graduallysqueezed together as the tip and IOL (not shown) pass through the nozzle50. In FIG. 4A, the arms 72, 74 are in an expanded state when in aproximal portion of the nozzle 50. In FIG. 4B, as the tip 70 isadvanced, the arms 72, 74 are squeezed by the inner walls defining thenozzle lumen 56 and are changing to a compressed or contracted state. InFIG. 4C, the arms 72, 74 are in a contracted state when in a distalportion of the nozzle 50. Note in FIG. 4A that the distal ends of thefingers 76, 78 are bypassing each other, in FIG. 4B they are abuttingthe inside surface of the arms 72, 74, and in FIG. 4C they are bentinward. All the while, the arms 72, 74 together with the fingers 76, 78span across the entire lumen 56 in at least one direction (but not all)to keep the IOL system component in front of the tip 70 and prevent theIOL system component from becoming stuck between the tip 70 and theinner wall of the nozzle lumen 56. In a plane orthogonal to the oneillustrated, it would be apparent that the lateral sides of the arms 72,74 and the fingers 76, 78 are not in contact with the inner wall of thenozzle lumen 56, thereby reducing friction.

The injector 10 may be used with a wide variety of IOL system componentsincluding modular IOL system components and non-modular IOLs (e.g.,unitary and/or monolithic IOLs). By way of example, not limitation, theinjector may be used to inject a base component and an optic componentthat form a modular IOL system when assembled. The base and optic may beinjected into the eye separately and assembled in the eye, or assembledoutside the eye and injected into the eye together. A description of anexample base component 400 is provided with reference to FIGS. 5 and 5A,and a description of an example optic component 500 is provided withreference to FIG. 6. Further details regarding a similar modular IOLsystem configuration may be found in U.S. Non-provisional patentapplication Ser. No. 15/585,901, filed May 3, 2017 and entitledIntraocular Lens Designs for Improved Stability, which is incorporatedherein by reference.

With reference to FIG. 5, the base 400 includes an annular ring 402defining a center hole 404. A pair of haptics 406 extend radiallyoutward from the annular ring 402. The annular ring 402 includes a lowerrim 408, an upper rim 410 and an inward-facing recess 412, into whichthe lens 500 may be inserted to form the modular IOL system.

The lower rim 408 may include a pair of diametrically opposed (180degrees) folding notches 414, and the upper rim 410 may include acorresponding pair of folding notches 416. Folding notches 414, 416 maybe aligned with the mid portions of the haptics 406 and are configuredto provide a natural folding crease to fold the base in half in theloading cartridge 40 of the injector 10, thereby aligning the midportion of the haptic with the plunger tip 70. Notches 414, 416 may alsoprovide access for a probe (e.g., Sinskey hook) intra-operatively, whichallows the base 400 to be more easily manipulated. The haptics 406 mayinclude holes 415 adjacent the annular ring 402 for intraoperativemanipulation with a probe. A series of vent holes 413 may be distributedaround the upper rim 410.

With reference to FIG. 5A, which is a cross sectional view taken alongline A-A in FIG. 5, the recess 412 may have a tapered profile defined byhorizontal posterior surface 418, a vertical lateral or outer surface422 and a flared anterior surface 426 extending radially inward andanteriorly outward from the vertical outer surface 422. The insidediameter of the posterior rim 408 may be smaller than the insidediameter of the anterior rim 410. With this arrangement, the lens 500may be placed through the circular opening 404 defined by the anteriorrim 410 to land or rest upon the posterior rim 408, and the flaredanterior wall 426 together with the flared posterior wall 428 may act asa funnel to guide the tabs 504 and 506 of the lens 500 into the deepportion of the recess 412. A pair of square edges 417 may extend aroundthe posterior periphery of the annular ring 402 to help reduce cellularproliferation (posterior capsular opacification or PCO) onto the lens500.

With reference to FIG. 6, a top (anterior) view of the lens 500 isshown. The lens 500 may include an optic portion 502 and one or moretabs 504 and 506. As shown, tab 504 is fixed, whereas tab 506 may beactuated. In one example, tab 504 is more resistant to deformation(e.g., compression and/or expansion) in a radial direction than tab 506.Fixed tab 504 may include a thru hole 508 so that a probe (e.g., Sinskeyhook) or similar device may be used to engage the hole 508 andmanipulate the tab 504. Actuatable tab 506 may be actuated between acompressed position for delivery into the hole 404 of the base 400, andan uncompressed extended position (shown) for deployment into the recess412 of the base 400, thus forming an interlocking connection between thebase 400 and the lens 500. It also is contemplated that actuatable tab506 may be inserted into recess 412, and may be actuated between thecompressed position to facilitate entry of fixed tab 504 into recess412, and the uncompressed extended position to insert fixed tab 504further into recess 412 to form the interlocking connection between base400 and lens 500.

Actuatable tab 506 may include two arms 510 and 512 that extend radiallyoutward in different (e.g., opposite) directions. In one example, anobtuse angle may be formed between the directions. Each arm 510, 512 mayhave one end connected to the edge of the optic 502 and the other endconnected to middle arm 511. Hinge portions may connect ends of arms 510and 512 to optic 502, and may connect other ends of arms 510 and 512 tomiddle arm 511. Each of arms 510, 511, and 512 may include one or morelinear portions. In one example, middle arm 511 may include two linearportions meeting at a mid-portion of middle arm 511. Middle arm 511 maybe angled radially inward as shown with an apex in the mid-portionthereof. The apex may be a hinge portion. Portions of optic 502 and arms510, 511, and 512 may form a ring around a aperture through actuatabletab 506. Dimensions of that aperture may change as actuatable tab 506moves between compressed and extended states.

With this configuration, the actuatable tab 506 may bend along all threearms 510, 511, 512, and/or may bend along the hinge portions, whenmoving between its compressed and extended states, but may provide asingle portion (apex of middle arm 511) for initial insertion intorecess 412 of base 400. A rim 514 may extend around the perimeter of theoptic 502, terminating shy of the arms 510 and 512, thus allowing thearms 510 and 512 to fully compress against the edge of the optic 502.The edge of optic 502 may be planar, and may contact one or more planarsurfaces of arm 510 and/or arm 512. The rim 514 of the lens 500 may havean outside diameter that is greater than the inside diameter of theposterior rim 408 of the base 400 such that the lens 500 doesn't fallthrough the opening 404 of the base 400 and such that the lens 500 iscircumferentially supported around its perimeter by the posterior rim408 of the base 400. A gusset with a guide hole 516 may be disposedbetween the two arms 510 and 512 to facilitate manipulation by a probe.Similarly, a guide hole 508 may be provided in the fixed tab 504 toprovide access for a probe (e.g., Sinskey hook) or similar device tomanipulate the fixed tab 504 into the recess 412 in the base 400. Anotch 518 may be provided in the fixed tab 504 to provide asymmetry as avisual indicator that the anterior side is up (rather than down) whenthe notch is counter-clockwise of the hole 508.

The base 400 and lens 500, including the alternative embodimentsdescribed herein, may be formed by cryogenically machining and polishinghydrophobic acrylic material. Optionally, the base 400 may bemanufactured by forming two (anterior and posterior) components andadhesively connecting them together. For example, the two components maybe cryogenically machined hydrophilic acrylic connected together by aU.V. curable adhesive. Alternatively, the two components may be formedof different materials adhesively connected together. For example, theanterior component may be formed of hydrophilic acrylic which does notadhere to ocular tissue, and the posterior component may be formed ofhydrophobic acrylic which does adhere to ocular tissue.

As a further alternative, the base 400 may be manufactured by cryogenicmachining the first component and over-molding the second component. Thefirst component may include geometric features that become interlockedwhen over-molded, thus mitigating the need for adhesive to connect thecomponents. For example, the base 400 may be manufactured by cryogenicmachining of hydrophilic acrylic to form the posterior component, andover-molding the anterior component of a moldable material such assilicone.

Whether made of a single component, two components adhesively connected,or two components with one component molded over the other, all or aportion of the annular ring 402 may include coloration to enhance theability to visualize the tabs 504, 506 relative to the recess 412 tobetter determine if the tabs 504, 506 are anterior to, inside orposterior to the recess 412. In this embodiment, the annular ring 402may be a first color and the tabs 504, 506 may be a second (different)color. Alternatively, if the annular ring 402 comprises an anteriorcomponent and a posterior component, either or both of the anterior andposterior components may be a first color and the tabs 504, 506 may be asecond (different) color. By way of example, the annular ring 402 may bea blue color (blue dye monomer additive) and the tabs 504, 506 may be anatural (transparent) color. In this example, when viewed anterior toposterior, and because the anterior rim 410 has a larger inside diameterthan the posterior rim 408, the inside portion of the posterior rim 408may appear light blue, and the overlap of the anterior rim 410 andposterior rim 408 may appear dark blue. With this differentiation incolor, the position of the tabs 504, 506 relative to the recess 412 maybe visually more apparent to more easily facilitate assembling the optic500 to the base 400.

As may be appreciated from the forgoing description, the optic 500 maybe similarly sized to a conventional IOL and the base 400 may beslightly larger to allow the optic 500 to fit therein. A conventionalloading cartridge may be used for both the base 400 and the optic 500.However, it may be desirable to use a modified loading cartridge 40 forthe base as described with reference to FIG. 7-7C.

With specific reference to FIGS. 7 and 7A, the loading cartridge 40includes a first folding wing 42, a second folding wing 44 with alocking mechanism, and a chamber 46 configured to hold the base 400 whenthe wings 42, 44 are closed. With reference to FIG. 7B, which is across-sectional view taken along line B-B in FIG. 7A, the sides of thechamber may include shoulders 48 such that a proximal width of thechamber 46 is wider than a distal width of the chamber 46. By way ofexample, not limitation, the proximal width may be about 7.9 mm and thedistal width may be about 6.6 mm. This configuration defines a taperedchamber lumen that gradually compresses the relatively larger base 400into the proximal portion of the nozzle lumen 56 as the plunger 30pushes the base 400 distally. In addition, as seen in FIG. 7C, theshoulders 48 abut the annular ring 402 of the base 400 thereby providinga backstop for the base 400 to maintain the axial (longitudinal)position of the base 400 in the loading cartridge 40, particularly whenthe tip 70 of the plunger 30 engages the proximal side of the base 400.The folding notches 414 of the base 400 may be aligned with thelongitudinal axis of the loading cartridge 40 to provide a hinge foruniform diametric folding of the base 400 when the wings 42, 44 of thecartridge 40 are closed.

As described previously, the base 400 and/or optic 500 may be loaded orpre-loaded in the chamber 46 of the loading cartridge 40. If pre-loaded,a holder 100 may be used to hold the base 400 or optic 500 in thechamber 46 of the loading cartridge 40 while packaged and shipped asshown in FIGS. 8-8B. Holder 100 may include a holding plate 102, aconnector portion 104, an arm 106 and a retaining pin 108. The holdingplate 102 may cover all or a portion of the base 400 or optic 500 in thechamber 46. The connector portion 104 may attach to the wing 44 of thecartridge 44, and the arm 106 may engage the other wing 42 of thecartridge 40 via one or more slots. The retaining pin 108 may extendfrom a lateral edge of the holding plate 102 at position recessed from aproximal edge of the holding plate 102 such that it is positionedbetween the annular ring 402 and the trailing or proximal haptic 402 ofthe base 400 as shown in FIG. 8B. This arrangement, when combined withthe shoulders 48 of the cartridge, retain the base 400 and limitmovement in all directions during packaging and shipping.

The foregoing discussion of the disclosure has been presented forpurposes of illustration and description. The foregoing is not intendedto limit the disclosure to the form or forms disclosed herein. Althoughthe disclosure has included description of one or more embodiments andcertain variations and modifications, other variations and modificationsare within the scope of the disclosure, e.g., as may be within the skilland knowledge of those in the art, after understanding the presentdisclosure. It is intended to obtain rights which include alternativeembodiments to the extent permitted, including alternate,interchangeable and/or equivalent structures, functions, ranges or stepsto those claimed, whether or not such alternate, interchangeable and/orequivalent structures, functions, ranges or steps are disclosed herein,and without intending to publicly dedicate any patentable subjectmatter.

While principles of the present disclosure are described herein withreference to illustrative embodiments for particular applications, itshould be understood that the disclosure is not limited thereto. Thosehaving ordinary skill in the art and access to the teachings providedherein will recognize additional modifications, applications,embodiments, and substitution of equivalents all fall within the scopeof the embodiments described herein. Accordingly, the invention is notto be considered as limited by the foregoing description.

1-20. (canceled)
 21. An intraocular lens system, comprising: a base,comprising: an annular body including an upper rim and a lower rim, anopening extending through the annular body, a first pair ofdiametrically opposed folding notches in the upper rim, and a recessextending circumferentially about the opening; and a lens configured forinsertion into and removable from the base, the lens comprising: acentral optic, a first tab extending radially away from the centraloptic, the first tab including a first arm extending radially away fromthe central optic, a second arm extending radially away from the centraloptic, and a third arm extending between the first arm and the secondarm, wherein one or more of the first, second, and third arms isconfigured to deform to move the first tab between a compressed stateand an extended state, and wherein in the extended state of the firsttab, an obtuse angle is formed between the first and second arms. 22.The intraocular lens system of claim 21, wherein the lens furthercomprises a second tab, the second extending radially away from thecentral optic, wherein the second tab is more resistant to compressionthan the first tab.
 23. The intraocular lens system of claim 21,wherein: the first arm includes a first hinge portion, the second armincludes a second hinge portion, and the third arm includes a thirdhinge portion, wherein the first, second, and third hinge portions areconfigured to bend as the first tab moves between the extended andcompressed states.
 24. The intraocular lens system of claim 21, whereinthe first, second, and third arms, and the central optic, form a closedring surrounding an aperture, and wherein a width of the aperturenarrows as the first tab moves to the compressed state.
 25. Theintraocular lens system of claim 21, wherein a central portion of thethird arm includes an apex of the third arm, the apex being aradially-outermost portion of the third arm.
 26. The intraocular lenssystem of claim 21, wherein each of the first, second, and third armshas at least one linear section.
 27. The intraocular lens system ofclaim 25, wherein the third arm has a first linear section and a secondlinear section, the first and second linear sections being linked at theapex.
 28. The intraocular lens system of claim 27, wherein an obtuseangle is formed between the first and second linear sections.
 29. Theintraocular lens system of claim 21, wherein the base further comprisesa pair of haptics extending radially outward from the annular body and asecond pair of diametrically opposed folding notches in the lower rim.30. The intraocular lens system of claim 29, wherein the first pair andthe second pair of diametrically opposed folding notches are configuredto provide a folding crease for folding the base.
 31. The intraocularlens system of claim 29, wherein the first pair and the second pair ofdiametrically opposed folding notches are aligned with a mid portion ofeach of the haptics.
 32. The intraocular lens system of claim 21,wherein the lens further comprises a plurality of holes and at least onehole is located between the first arm and the second arm.
 33. Anintraocular lens system, comprising: a base, comprising: an annular bodyincluding an upper rim and a lower rim, an opening extending through theannular body, a first pair of diametrically opposed folding notches inthe upper rim, and a second pair of diametrically opposed foldingnotches in the lower rim, and a recess extending circumferentially aboutthe opening; and a lens configured for insertion into and removal fromthe base, the lens comprising: a central optic, and a fixed tabprotruding radially away from the central optic, the fixed tabincluding: a first side projecting from a first radially-outer surfaceof the central optic, wherein a first angle is formed between the firstside and the first radially-outer surface, and a second side projectingfrom a second radially-outer surface of the central optic, wherein asecond angle is formed between the second side and the secondradially-outer surface, wherein magnitudes of the first and secondangles are different.
 34. The intraocular lens system of claim 33,wherein the lens further comprises an actuatable tab protruding radiallyaway from the central optic.
 35. The intraocular lens system of claim34, wherein the fixed tab is more resistant to deformation in a radialdirection than the actuatable tab.
 36. The intraocular lens system ofclaim 33, wherein the lens further comprises a plurality of holes and atleast one hole is located where the fixed tab meets the central optic.37. The intraocular lens system of claim 33, wherein the fixed tabincludes at least one notch located at the first side, the second side,or both.
 38. The intraocular lens system of claim 33, wherein the basefurther comprises a pair of haptics extending radially outward from theannular body.
 39. The intraocular lens system of claim 38, wherein thefirst pair and the second pair of diametrically opposed folding notchesare aligned with a mid portion of each of the haptics.
 40. Theintraocular lens system of claim 38, wherein each haptic includes a holeadjacent the annular body.